The continuing saga of Trinity's dad...

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JoeyB

JoeyB

Member Since 2013
I've been testing somewhat regularly the last 5 days or so now as evidenced by Trinity's SS below.

Her dose prior to the SS testing was 1 unit BID. Since the initial results were so high, I did up her to 1.5 units BID.

Now that we are 4-5 days into this dosage, and her numbers still remain high overall, I would assume from what I've read that she needs another increase?

I don't want to go too fast with this, but at the same time, would like to see her BG results far lower then they have been.

With the curves present in her SS, as well as her occasional chaotic results. Could someone fill me in a bit on what they think is going on at the moment?

Clinical observations are somewhat chaotic. She seems to be doing well over all, but there are times when she obviously has little to no energy, and moves a bit stiffly like she is in a bit of pain. Her appetite is pretty good, and I'm continuing her move towards a 100% wet diet.

Her urine isn't showing ketones on the stix, but the quantity is twice her usual amount, which is down from her 3-5 times the normal amount 6 weeks ago when this all started. Since the initial decrease in urine during the first week of insulin, she's not shown any further progress in that direction.

It seems like I've hit a plateau in her recovery, and I'd like to continue it in the right direction at the right time. Ideas please?

EDIT: Something new happened tonight on her BG curve. Lowest #'s since I've started testing her, and she's been tired, sore, and hungry. Still fastidious with her post litter box cleanup though, so there are some positive signs as well.
 
Good to see you're getting testing done regularly. :thumbup

Last nights numbers were great compared to what she's had in the past. You have to realize, she's not used to that, she may not 'feel' right. And by the same token, she may bounce up high in response to those lower numbers. Hang in there.

IMO I don't think you should raise her dose again just yet, give her another couple days. No 2 cats adjust to dose at the same time. Some adjust in 3 days, some take as long as a couple weeks, although that's unusual. It looks like she may be adjusting, with her showing those lower numbers. Give her a little more time to settle in to the dose and then decide. Dose adjustments are made determined by the nadir, the lowest number in the cycle. I'll have to check, but I don't think 110 warrants an increase, let me check for you.

With the testing you're doing, it will be much easier for someone to advise you on dosing, since you have the data to show now. Experienced members are very leary of offering dose advice without enough information.

You're doing a great job!
 
Backatcha, here's the info on dosing if following SLGS and it's pretty much the same no matter what program you're following:

If the lowest point of the curve is above 150 mg/dl (8.3 mmol/L), increase the dose by 0.5 unit.
If the lowest point of the curve is between 90 and 149 mg/dl (5.0 and 8.2 mmol/L), keep the dose the same.
If the lowest point of the curve is below 90 mg/dl (5.0 mmol/L), decrease the dose by 0.5 unit.

According to this, she falls between 90 and 149, so keep her dose.

Because she has been so high for so long, she will quite probably bounce around some and it take's time for that to adjust on it's own. I can tell you all about a high number bouncy cat! :o My Lucian was the worst! Thankfully, with a change of insulin he is doing a thousand times better. But he is one in a million, it's rare for a cat not to respond to the insulin like he did.

Give your girl a little time. Gotta have patience. Battling FD is a marathon, not a sprint.
 
Great job on all those tests- the curve last night was spectacular! Data is so important and you are getting lots of it :-D

A few things you mentioned-
Insulin- since she showed a drop into the blues after 5 DAYS (not doses) I would keep her on it for a little bit. One thing you might want to take notes on is her food. Write the carb count on the can lids and try to feed just one carb % for two weeks. Food will effect her levels completely so if you do FF or any other kind buy a case of what she will eat in that % and just feed that. This tells you how sensitive Trinity is to carbs- or not. If you currently feed only one type/kind than you know how she is on a steady carb diet and her fluctuations are just her body reacting to the insulin. Dry food with high carbs will keep her high so take that into account. My Sneakers is very carb sensitive and would hold on to those carbs for up to 3 days before she leveled off. If you are transitioning to wet keep testing- she might have eaten more wet during the day and less dry so her numbers were lower so holding the dose longer might be a good idea.

Food- a biggie here. Remember at these numbers she is an unregulated diabetic. That means she doesn't get all the nutrients from her food as she eats them- her little receptors just aren't there to catch them so she is literally starving while eating everything you give her. Sneakers was eating almost 20 ounces a day while unregulated. Now she eats 6-8 oz (sometimes less) and has been ever since her numbers were consistently under 300.

You are doing great to start testing and wanting to do so much for Trinity.
 
Since you're still working on regulation, you should test for ketones. Ketones form as a by-product of fat breakdown. Too many may indicate diabetic ketooacidosis, a potentially fatal, expensive to treat complication of diabetes.

You'll need KetoStix (test ketones only) or KetoDiaStix ( tests ketones and glucose) or a generic equivalent . There are a urine testing few tips in my signature link Secondary Monitoring Tools.
 
hmjohnston said:
Great job on all those tests- the curve last night was spectacular! Data is so important and you are getting lots of it :-D

A few things you mentioned-
Insulin- since she showed a drop into the blues after 5 DAYS (not doses) I would keep her on it for a little bit. One thing you might want to take notes on is her food. Write the carb count on the can lids and try to feed just one carb % for two weeks. Food will effect her levels completely so if you do FF or any other kind buy a case of what she will eat in that % and just feed that. This tells you how sensitive Trinity is to carbs- or not. If you currently feed only one type/kind than you know how she is on a steady carb diet and her fluctuations are just her body reacting to the insulin. Dry food with high carbs will keep her high so take that into account. My Sneakers is very carb sensitive and would hold on to those carbs for up to 3 days before she leveled off. If you are transitioning to wet keep testing- she might have eaten more wet during the day and less dry so her numbers were lower so holding the dose longer might be a good idea.

Food- a biggie here. Remember at these numbers she is an unregulated diabetic. That means she doesn't get all the nutrients from her food as she eats them- her little receptors just aren't there to catch them so she is literally starving while eating everything you give her. Sneakers was eating almost 20 ounces a day while unregulated. Now she eats 6-8 oz (sometimes less) and has been ever since her numbers were consistently under 300.

You are doing great to start testing and wanting to do so much for Trinity.
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The Fancy Feast classics that I've been feeding her average 6-9% carbs, and the Nature's Variety Instinct dry is about 9% as well. I've been putting less and less dry out over the last few days, wanting to wean both cats from it entirely, while at the same time using up what dry food there is left. (About half a bag at this point)

I've stopped the Temptations treats completely since the last bag ran out about 2 days ago. Perhaps that was part of what was keeping her numbers so high?

I guess my biggest concern is the fact that she has been on insulin for over 6 weeks now, and her test results are in the same 300+ range that she was in when originally diagnosed. I know everyone keeps saying be patient, but it's hard sometimes when she stills has the bad nights like last night.

To be honest, her clinical symptoms are minimal most of the time compared to others in my same time frame that I've read about. It's just the rough periods that want me to see her numbers much lower, much faster.

I will keep her carb intake at it's current rate for the time being. It's affordable, and easy to get the products I'm using. I assume that some cats are more tolerant of carbs, while others need their carbs brought even lower to fully regulate. Still trying to figure out where my Trinity is on that scale.
 
Yes Trinity still gets those 300's pre-shot, but last night, she dropped into the blues and the LOW blues at that. Her body is not used to those low BG numbers so the liver released counter regulatory hormones and dumped more glycogen (sp?) into her system causing her to bounce up high.

It can take up to 72 hours for a bounce to clear, so you need to wait it out.

Remember, this is a marathon not a sprint. It took time for Trinity to become diabetic, it will take time for her pancreas to heal and start producing some of it's own insulin again.

We all like to compare our cats to others that are here on the boards, but ECID. Hormones work differently in every cat and insulin is a hormone.

You already said you see improvement in the clinical symptoms. We'll get Trinity's BG numbers leveled out eventually.
 
Just a quick note. She not doing as poorly as you think. You're forgetting all the improvements, just because the numbers haven't changed much.

Take a look at my Lucian's SS, before July 23, back to Jan when he was dx'd. That's out of control! Trinity doesn't come close. :-D

Now that you gotten rid of high carb snacks, keeping her diet carbs to a low level, just give her time to adjust. Up until a couple days ago, she was eating kitty candy! She showed much lower numbers since not having the treats and then a little bounce. Give it time, she'll level off.

Around here, we call it "Putting On Our Patience Pants". If you need to borrow a pair, I have several! :lol:
 
nckitties3 said:
Just a quick note. She not doing as poorly as you think. You're forgetting all the improvements, just because the numbers haven't changed much.

Take a look at my Lucian's SS, before July 23, back to Jan when he was dx'd. That's out of control! Trinity doesn't come close. :-D

Now that you gotten rid of high carb snacks, keeping her diet carbs to a low level, just give her time to adjust. Up until a couple days ago, she was eating kitty candy! She showed much lower numbers since not having the treats and then a little bounce. Give it time, she'll level off.

Around here, we call it "Putting On Our Patience Pants". If you need to borrow a pair, I have several! :lol:
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Thank you very much for your post!

I've been sitting here comparing Trinity's BG #'s to many other users SS's all day long to see just where she might be in her overall performance. You're 100% correct that she is not really doing all that badly and my stress level is reduced, I agree.

I just want my kitty better now! BIG SMILE while pulling up the Patience Pants!
 
I was like you back in May when I got my sugarfoster...

I thought that if I start testing and doing curves, giving proper insulin, giving him a low-carb, healthy diet (mostly raw), and fatten him up that he would be off insulin in no time. Then I was offered a pair of patience pants... No matter how much you attend to it, this disease takes its time. Three and a half months later I am just beginning to see some good low numbers but no where near regulated or off insulin. So don't get frustrated. Just know that you are showing Trinity so much love and care by all the changes you have made (especially weaning off the Temptations). You are doing your part and now you just have to wait for Trinity's pancreas to rest and heal.

Great job!!
 
Agree with Robin.

You're going to hear ECID so much you'll hate the words! :evil: But it is so true!

I see cats that come in dx'd and 3 weeks later be OTJ. Why can't that be my Lucian?!?! Because it can't. Ever cat is different. Some take a long time, some never go OTJ. As long as they are healthy and happy, it doesn't matter.

You're doing a great job! :thumbup Why don't you start posting a daily condo for Trinity, so we can see what she's up to? If you have time of course, a lot of people don't and only post occasionally, that's ok too. We are glad you're here and want to keep up with how Trinity's doing. :YMHUG:
 
nckitties3 said:
Agree with Robin.

You're going to hear ECID so much you'll hate the words! :evil: But it is so true!

I see cats that come in dx'd and 3 weeks later be OTJ. Why can't that be my Lucian?!?! Because it can't. Ever cat is different. Some take a long time, some never go OTJ. As long as they are healthy and happy, it doesn't matter.

You're doing a great job! :thumbup Why don't you start posting a daily condo for Trinity, so we can see what she's up to? If you have time of course, a lot of people don't and only post occasionally, that's ok too. We are glad you're here and want to keep up with how Trinity's doing. :YMHUG:
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Robin and nckitties...thank you very much for your supportive posts. I'm learning to live with the patience pants, and realizing I was expecting too much, too quickly now.

I've posted her daily condo for today already, thanks for the suggestion nckitties! I've usually got more then enough time to do so every day, and think it will become a good part of my daily habits to take care of my Trinity.

To be quite honest with you nckitties, your positive attitude has definitely rubbed off on me after seeing Lucian SS. If you can still be doing so well after all you went through at the beginning of those numbers, I can surely keep my head up and keep as positive for my Trinity.

Again, thanks to all that have given me these little bits of support along the way, they are needed, and making a heck of a difference!
 
I just noticed, some of the FF you're feeding is 12%, that is not considered low carb. Low carb is under 10%. It's fine for the other kitty as long as you are sure Trinity can't get to it. That's considered a med carb food and shouldn't be used unless Trinity is dropping TOO low, to help bring her up. For an FD kitty, 10% is max, lower if at all possible.

I feed between 4-8% and only on occasion a 9%. I think his Mixed Grill is less than 4%. I always keep a couple cans of med carb, 14-15% for when he's low.

You do have your HYPO Kit right? A few cans of high carb food, some kayo syrup or honey, plenty of test strips? If not, you need to get that together. Being too high is a pisser, but being too low can be fatal.
In my kit, I also have a piece of paper with the name, address, phone #, and directions to the nearest ER Vet, since I've never been there and, if needed, sure wouldn't have time to look it up.

You are doing such a great job, I want to make sure that you have everything you might need. Although your med and high carbs foods may not be needed for a while and rarely used, you don't want to be without them, because they will drop when you least expect it. :o

Here's to healthy and happy kitties! drinking24

By the way, the name's Debbie, see below?
 
nckitties3 said:
I just noticed, some of the FF you're feeding is 12%, that is not considered low carb. Low carb is under 10%. It's fine for the other kitty as long as you are sure Trinity can't get to it. That's considered a med carb food and shouldn't be used unless Trinity is dropping TOO low, to help bring her up. For an FD kitty, 10% is max, lower if at all possible.

I feed between 4-8% and only on occasion a 9%. I think his Mixed Grill is less than 4%. I always keep a couple cans of med carb, 14-15% for when he's low.

You do have your HYPO Kit right? A few cans of high carb food, some kayo syrup or honey, plenty of test strips? If not, you need to get that together. Being too high is a pisser, but being too low can be fatal.
In my kit, I also have a piece of paper with the name, address, phone #, and directions to the nearest ER Vet, since I've never been there and, if needed, sure wouldn't have time to look it up.

You are doing such a great job, I want to make sure that you have everything you might need. Although your med and high carbs foods may not be needed for a while and rarely used, you don't want to be without them, because they will drop when you least expect it. :o

Here's to healthy and happy kitties! drinking24

By the way, the name's Debbie, see below?
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Thanks for the heads up on the carb % in the foods. I thought I was doing good at 9-12%. You can be sure I'll make the effort to get her eating the 6-9% stuff now. Not all the FF is that low, I have to check them all. Figures she likes the higher carb stuff better, don't it?

And yes, I do have the hypo kit prepared. Got some old Meow Mix she likes, and will eat at any time, the ER # for the vet, and karo syrup.

Hiya Debbie! Thanks for your bits of support along the way, this is harder then I thought, but the habits are forming very quickly to take care of my sugar kitty. I'm sure it'll get better from here once I stay on top of EVERYTHING that needs to be! Boy there are alot of pieces to this puzzle!!!
 
Actually, we don't use dry for a possible hypo, as it takes too long to absorb.

High carb gravied foods (we use the gravy) or Karo/honey/syrup work the best to bring up numbers quickly.
 
BJM said:
Actually, we don't use dry for a possible hypo, as it takes too long to absorb.

High carb gravied foods (we use the gravy) or Karo/honey/syrup work the best to bring up numbers quickly.
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I'd read that somewhere and forgotten it. Guess it's the trash for the leftover Meow Mix then. Thanks for the heads up!
 
I knew we weren't supposed to use dry, but couldn't remember why. ;-) I personally don't try to use just the gravy cause Lucian will tear you up for 14% beef and gravy. :lol:

A bit of info you do need to remember: When the time comes that you need to 'steer' her with food because she's running too low, always feed 1 or 2 tsps ONLY at a time. You may be feeding and testing every 30 mins or less, the LAST thing you want is for her to be too full to eat it. Too often, especially newbee's that don't know better, will freak out the 1st time their cat hits 50, they'll feed a ton of food. Then 30 mins later when they test and need to give more, cat won't eat. Not a good thing. nailbite_smile So when you have to do this, and you will, please only give a small amount each time so she'll gladly eat it next time. This can go on for hours, depending on where she is in her cycle.

And you're right, the more carbs the better they like it. All the food in my kit is FF Gravy Lovers, at 21-23%.

You shouldn't have a problem finding a big enough variety of low carb FF, to keep her below 10%. I use Friskees and there's at least 15, although they won't eat a couple. Mine went cold turkey off dry, all 3 of them and it was tough. At first, they were much pickier, but 8 months later, nary a problem. Lucian hasn't tried to bury the bowl in a couple months. :-D

I counted, right this minute, I have 9 flavors, only 1 is 9%, 1 is 8% and the rest if 3-7%. Out of 9, I have 7 under 7 carbs. I'm sure FF has just as many, I just can't afford to feed it except for my hypo bag.
 
JoeyB said:
..I'd read that somewhere and forgotten it. Guess it's the trash for the leftover Meow Mix then. Thanks for the heads up!
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Donate it to a rescue or TNR group. They can give it someone where something is better than nothing.
 
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